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Financial Planning Worksheet


Date_____________________________ SSN_ _____________________________ Rate____________________________

Name______________________________________________ Age_____________________________________________

Pay Grade__________________________________________ Yrs. in Svc._______________________________________

Date Reported/PRD (Transfer)__________________________________________________________________________

Marital Status______________________ Spouse’s Name_ ____________________ Age_____________________________

Spouse’s Place of Employment__________________________________________________________________________

Number of Children and Ages___________________________________________________________________________

Home Address_______________________________________________________________________________________

Work Telephone______________________________________ Home Telephone___________________________________

Command & Referred By (Self, CMD, NMCRS, FFSC, etc.)_ __________________________________________________

Amount of SGLI Elected_ ______________________________ Amount of FSGLI Elected____________________________

TSP Monthly Contribution______________________________ MGIB Monthly Contribution___________________________

STATEMENT OF NET WORTH


ASSETS LIABILITIES
Cash on hand $_____________ Signature Loans $_ ___________
Checking accounts $_____________ Auto Loans or Leases $_ ___________
Savings accounts $_____________ Consolidation Loans $_ ___________
Certificates of Deposit $_____________
Student Loans $_ ___________
Cash value of Life Insurance $_____________
NEX/AAFES (Star Card) $_ ___________
U.S. Savings Bonds $_____________
Mutual Funds/Money Market $_____________ Department Store Credit Cards $_ ___________
Stocks/Bonds $_____________ Other Credit Cards $_ ___________
College Funds $_____________ NMCRS (Loan) $_ ___________
401(k)/403(b)/TSP $_____________ Other (Friends, Relatives, etc.) $_ ___________
Other (IRAs, etc.) $_____________ Advance/Over Payments $_ ___________
Real Estate (Market Value) $_____________ Mortgages-Balances Due
Home $_____________ Home $_ ___________
Rental Property $_____________ Rental Property $_ ___________
Other (Vac Home/Trailer/Time Share) $_____________ Other (Vac Home/Trailer/Time Share) $____________
Personal Property
Vehicles/Motorcycles/Boats $_____________
Furniture $_____________
Jewelry $_____________ TOTAL ASSETS $_ ____________
Other (Collectibles, etc.) $_____________
TOTAL LIABILITIES $_ ____________
Counseling Provided By:___________________________
Counselor Phone #:_______________________________
NET WORTH
Appointment Date:_______________Time:_____________
(Assets - Liabilities) $_ ____________
Place:__________________________________________
PAGE 

MONTHLY INCOME
ENTITLEMENTS ACTUAL PROJECTED REMARKS
* Base Pay Monthly Contribution Amount
Basic Allowance for Housing (BAH I or II)
Overseas Housing Allowance (OHA)
Basic Allowance for Subsistence (BAS)
Family Separation Allowance (FSA)
* Flight Pay/Diving Pay/Flight Deck Pay
* Submarine Pay
* Other Hazardous Duty Pay
* Sea Pay
Taxable COLA
Other (tax exempt/allowance eg. COLA/FSSA)
TOTAL MILITARY COMPENSATION (A)
* Taxable pay ( ) Excludes pretax ded for TSP/MGIB

DEDUCTIONS ACTUAL PROJECTED REMARKS


ALLOTMENT For/ends?
ALLOTMENT For/ends?
ALLOTMENT For/ends?
ALLOTMENT For/ends?
Meal Collection Deduction
Family SGLI (For Spouses)
SGLI and T-SGLI
Uniform Services TSP
MGIB
FITW Filing Status Actual: Proj. Status:
FICA (Social Security) Base Pay Only, Excludes MGIB
FICA (Medicare) Base Pay Only, Excludes MGIB
State Income Tax State Claimed:
AFRH (Armed Forces Retirement Home)
Tricare Dental Plan (TDP)
Advance Payments Ends:
Over Payments Ends:
TOTAL MILITARY COMPENSATION (B)
CALCULATE NET INCOME ACTUAL PROJECTED REMARKS
Service Member’s Take Home Pay (A-B) $ $ Divide by 2 fr Payday Amount
Service Member’s Other Earnings (less taxes)
Spouse’s Earnings (less taxes)
ALLOTMENT
ALLOTMENT
ALLOTMENT
ALLOTMENT
Meal Collection Deduction
Family SGLI (For Spouses)
SGLI and T-SGLI
Uniform Services TSP
MGIB
Tricare Dental Plan (TDP)
Advance Payments
Over Payments
Child Support/Alimony (Received/Income)
Other Income (e.g. SSI, Rental Income)
TOTAL MONTHLY LIVING INCOME $ $ Actual:

*Note: Pay Entitlements are taxable. Allowance Entitlements are non-taxable.


PAGE 

MONTHLY SAVINGS AND LIVING EXPENSES


SAVINGS ACTUAL PROJECTED REMARKS
SAVINGS Emergency Fund (1-3 months) Monthly Contribution Amount
Goal: 10% of Net Income Reserve Fund
Actual Projected "Goal-Getter Fund
$ $ Investments/IRAs/TSP/etc.
TOTAL SAVINGS AND INVESTMENTS (10%)
LIVING EXPENSES ACTUAL PROJECTED REMARKS
HOUSEHOLD Furnishings
Maintenance/Repairs
Mortgage/Rent
Taxes/Fees
FOOD Dining Out
Groceries
Lunches include school and work lunches
Vending Machines
Meal Deductions
UTILITIES Cable/Satellite TV
Cellular/Pagers/Phone Cards
Electricity
Internet Service
Natural Gas/Propane
Telephone Local=$____Long Distance=$____
Water/Garbage/Sewage
CHILD CARE Allowances
Daycare
Support Include other dependant care
AUTOMOBILE Gasoline
Maintenance/Repairs
Other
CLOTHING Laundry/Dry Cleaning
Purchases ($50 monthly per person)
INSURANCE Automobile
Health/Life
Homeowners/Renters
SGLI/T-SGLI/FSGLI Both service member/Family SGLI
Tricare Dental
HEALTHCARE Dental
Eye Care
Hospital/Physician
Prescriptions
EDUCATION Books
Tuition/Fees include room and board
MGIB Montgomery GI Bill (MGIB)
CONTRIBUTIONS Charities
Club Dues/Association Fees
Religious
LEISURE Athletic Events/Sporting Goods include spectator sports
Books/Magazines
Computer Products (Software/Hardware)
DVD/VHS/Video Games/CDs purchase and rental
Entertaining
Lessons/Toys & Games dance, music, self-defense, tutor, etc.
Travel/Lodging
GIFTS Holidays
Birthdays/Anniversaries
PERSONAL CARE Barber/Beauty Shop
Beer/Liquor/Wine
Other ABC, Package Store, etc.
Tobacco Products
PET CARE Food/Supplies
Veterinarian/Service (boarding/grooming)
MISCELLANEOUS ATM Fees/Stamps/etc.
Other Recommend $50-$150 Buffer
TOTAL MONTHLY LIVING EXPENSES (70%) $ $ Actual:
PAGE 

INDEBTEDNESS 20%


CREDITOR PURPOSE MONTHLY BALANCE PROJECTED REMARKS APR %
PAYMENT PAYMENT (Mos Behind, Pd by Allotment, etc.)

1. US Govt. Advance Pay Automatic Deduction


2. US Govt. Over Payments Automatic Deduction
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TOTAL

SUMMARY

ACTUAL PROJECTED

NET INCOME (Bottom of Page 2)


SAVINGS & INVESTMENTS (Page 3) -
LIVING EXPENSES (Page 3) -
AMOUNT LEFT TO PAY DEBTS =
TOTAL MONTHLY DEBT PMTS (Page 4) -

SURPLUS OR DEFICIT =

DEBT TO INCOME RATIO


(Total Monthly Debt Payments ÷ Net Income x 100 = Debt-to-Income Ratio)
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ACTION PLAN
proposed options
Increase Income

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Decrease Living Expenses


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Decrease Indebtedness
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REFERRALS/RECOMMENDED TRAINING

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SETTING YOUR GOALS (Short & Long Term)

Goal COST / date wanted = monthly savings


to reach goal

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monthly spending PLAN


MONTH MONTH MONTH
TOTAL TAKE HOME PAY
BY PAYDAY 1st 15th 1st 15th 1st 15th

Note: Subtract all savings or living expenses deducted from pay (e.g. TSP) or paid by allotment.

P = Planned Expenses Budgeted


A = Actual Expenses Amount P A P A P A P A P A P A

Savings & Investments

Housing

Food

Utilities

Transportation

Clothes

Insurance

Health

Education

Contributions

Subscriptions

Personal

Entertainment

Dependent Care

Miscellaneous

Creditors: Do not include creditors paid by allotment

TOTALS
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monthly spending PLAN


Keep track of your daily expenses for two weeks
Keep a record of how you spend your money for the next two weeks. The secret is to record it when you spend
it. Using a “stickie” note in your wallet or purse will help you track your expenditures. When you go for your money
make a note on your “stickie”; (put the amount and what you spent your money on). At the end of the day, transfer
the recorded amounts to this record. Be sure to include bills paid, along with sodas, lunches, etc.

Remember this is for tracking your take home pay, don’t include allotments.
TAKE HOME PAY FOR TWO WEEKS Dates
DATE: DATE: DATE: DATE:

Item: Amount: Item: Amount: Item: Amount: Item: Amount:

DATE: DATE: DATE: DATE:

Item: Amount: Item: Amount: Item: Amount: Item: Amount:

DATE: DATE: DATE: DATE:

Item: Amount: Item: Amount: Item: Amount: Item: Amount:

DATE: DATE: DATE:

Take Home
Item: Amount: Item: Amount: Item: Amount: Pay: $ _________

Amount Spent: $ _________

Balance: +$ _________
(+ or -)
PAGE 

monthly spending PLAN


Keep track of your daily expenses for two weeks

TAKE HOME PAY FOR TWO WEEKS Dates


DATE: DATE: DATE: DATE:

Item: Amount: Item: Amount: Item: Amount: Item: Amount:

DATE: DATE: DATE: DATE:

Item: Amount: Item: Amount: Item: Amount: Item: Amount:

DATE: DATE: DATE: DATE:

Item: Amount: Item: Amount: Item: Amount: Item: Amount:

DATE: DATE: DATE:

Take Home
Item: Amount: Item: Amount: Item: Amount: Pay: $ _________

Amount Spent: $ _________

Balance: +$ _________
(+ or -)

Little Creek Newport News Norfolk Northwest Oceana Yorktown


462-7563 688-NAVY 444-2102 421-8770 433-2912 887-4606
Website: www.ffscnorva.navy.mil